Direct observation of quality of care in residential settings

Direct-observation procedures were used to objectively and efficiently assess several classes of service provided for individuals residing at two state facilities for the developmentally disabled. Time samples were taken of the condition of the clients' physical environment and of the clients themselves. The ongoing behavior of both clients and staff also was recorded. Each residence was observed at least three times during both regular work hours and evening/weekend hours. Results showed that both facilities scored high in the categories regarding the physical condition of the living areas, as well as the categories concerning the condition of the clients. Greater variability was seen in the data on client and staff behavior. More generally, the results indicate that time-sampling procedures can be used efficiently to collect data on multiple aspects of service delivery for large numbers of individuals.     

Evaluating a computational model of perceptual grouping by proximity

A formal approach to the phenomenon of perceptual grouping by proximity was investigated. Grouping judgments of random dot patterns were made by the CODE algorithm (van Oeffelen & Vos, 1982) and several related algorithms, and these judgments were compared with subjects’ grouping judgments for the same stimuli. Each algorithm predicted significantly more subject judgments than would be expected by chance. The more subjects agreed on how a given dot pattern should be grouped, the more successful was the algorithms’ ability to match the judgments for that pattern. CODE predicted significantly fewer subject judgments than did some of the other algorithms, largely because of its overemphasis on the extent of interactivity among dots as they are being grouped.     

Potentiation of the pressor response to stress by tolbutamide in dogs

Tolbutamide has previously been shown to amplify the pressor effects of “exogenous” catecholamines in conscious dogs, possibly due to sensitization of the α₁-adrenoreceptor-mediated vasoconstriction. The objective of this study was to examine if tolbutamide also amplifies the pressor effects of “endogenous” catecholamines released during psychological stress (classical Pavlovian aversive conditioning). Experiments were conducted in β-adrenoreceptor-blocked (propranolol, 1 mg/kg, i.v.) conscious dogs (n=4) trained in classical aversive conditioning. Conditioning was accomplished by following a tone (CS+) with a 1/2 second shock; another tone (CS-) was not followed by any shock and served as control. With saline pretreatment, aversive conditioning (i.e., CS+) increased mean arterial pressure (MAP) only by approximately 4.7% when compared to CS-, whereas with tolbutamide (45 mg/kg, i.v.) pretreatment, the increase in MAP induced by CS+ beyond what was induced by the CS- (approximately 6.2%) was significantly (p<0.05) larger than that with saline pretreatment. In isolated canine femoral arterial segments (n=4), the vasoconstrictor effect of phenylephrine (an α₁-agonist) at 5×10^?6M (which was the EC₅₀ value) was amplified by 2×10^?2M of tolbutamide from 54.0±2.0% to 66.9±2.1%. In conclusion, tolbutamide amplifies the pressor effects of “endogenous” catecholamines in conscious dogs, possibly by sensitization of the α₁-adrenoreceptor-mediated vasoconstriction. This mechanism of action is novel and has not been reported with other agents.     

Ingroup Versus Outgroup Perceptions of the Characteristics of High-Risk Youth: Negative Stereotyping1

Adolescents tend to categorize themselves and their peers into discrete ingroups and outgroups. A comparison of ingroup versus outgroup perceptions of the characteristics of high-risk youth was investigated. Based on current stereotype research, we examined the perspective that outgroup members would hold a more extreme stereotype of high-risk youth compared to the perceptions of ingroup members. A total of 955 7th- and 10th-grade southern California adolescents completed a questionnaire regarding the characteristics of their own peer group and a high-risk group. Support was obtained for an extremity of judgement effect. Outgroup youth perceived that their high-risk peers engaged in fewer school and nonschool low-risk activities, more high-risk activities, and greater drug use than did ingroup members. Outgroup members also held perceptions of high-risk youth as less likely to hold a white-collar job than did the ingroup members. The perceptions that adolescents have of these groups may play major roles in their own social behavior. The implications of these results for future tobacco use prevention programs are considered.     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

STIMULUS (INSTRUCTIONAL) FADING DURING EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three individuals with developmental disabilities were exposed to a series of assessment conditions to identify the source of reinforcement for their self-injurious behavior. In each case, self-injury occurred most often in instructional (demand) situations containing a brief time-out from the task contingent on self-injury, indicating that the behavior was an escape response (i.e., maintained by negative reinforcement). Treatment was implemented in a multiple baseline across subjects design and consisted of extinction (prevention of escape) plus instructional fading (initial elimination of instructions followed by their gradual reintroduction). Results showed that the combined treatment produced immediate and large reductions in self-injury that were maintained as the frequency of instructions was increased across sessions to match the original baseline rate of presentation. Results of a component analysis conducted with 1 subject suggested that stimulus fading accelerated the behavior-reducing effects of extinction.     

The effects of hormones,Type A behavior pattern,and provocation on aggression in men

Thirty-eight male college students, classified as either Type A or Type B based on their Jenkins Activity Survey (JAS-T) scores, competed in a reaction time task that allowed them to administer shocks to an increasingly provocative fictitious opponent. Salivary testosterone and cortisol were measured both prior to and after the task. Aggression was defined as the level of shock the subject was willing to set for the opponent. The results of this study indicate that a relationship exists between endogenous testosterone levels in men and direct physical aggression. Some evidence for the moderating effects of hormones on the level of aggression expressed by Type As was observed. No direct relationship between Type A and aggression was found.     

Three forms of stress in Cambodian adolescent refugees

Sixty-nine Cambodian adolescents and young adults were interviewed to determine their experience as children surviving the Pol Pot regime (1975–1979);their first-year experience of resettlement in this country; and their experience of stressful events during the past year. Current DSM-III-R diagnostic status was also determined. A strong relationship between earlier war trauma, resettlement strain, and symptoms of posttraumatic stress disorder (PTSD) was found. In contrast, the strongest relationship with depressive symptoms was found for recent stressful events. These results are discussed in light of current findings from stress and PTSD research.Dr. Clarke is Assistant Professor of Psychiatry in the Division of Child Psychiatry, Oregon Health Sciences University, Portland, Oregon. Dr. Sack is Director of the Division of Child Psychiatry and Principal Investigator of the Khmer Adolescent Project. Brian Goff is a Research Assistant.This project was supported by the National Institutes of Mental Health [NIMH] grant #5-RO1-MH42927-02, Dr. William H. Sack, M.D., Principal Investigator.